Study ranks NMC high in surgery care

Patients planning to have surgery might want to pick up the September issue of Consumer Reports magazine before choosing a hospital.

Newton and Rockdale medical centers both ranked among the top hospitals in Georgia at reducing the length of hospital stays for surgery and avoiding surgery deaths, according to a recent study by Consumer Reports magazine.

The study analyzed Medicare data for patients 65 years and older from 2009–2011 for nearly 2,500 hospitals across the country, and looked at 27 categories of common scheduled surgeries, focusing on the five most frequent surgeries: back surgery, replacements of the hip and knee and surgery to remove blockages in arteries in the heart (angioplasty) or neck (carotid artery surgery). Other surgeries affecting nearly every part of the body — brain, heart, lungs, stomach, neck, intestines, breast and prostate — were also examined.

High marks in surgery

Newton and Rockdale medical centers both earned above-average ratings in how their patients performed during and after surgery, according to the report.

Overall, Newton Medical had 65 percent fewer adverse events — which covers both prolonged stays and deaths — than predicted. Among the five most-frequent surgeries studied, Newton had only enough data for knee replacements, where it had 52 percent fewer adverse events than predicted. Rockdale Medical had 47 percent fewer adverse events, but didn’t have enough data in any of the five most common surgeries.

Dr. John Santa, an internist and primary care doctor and director for Consumer Reports Health Health Ratings Center, said the study focused on the five most frequent surgeries because they had the most data and showed the most variation among hospitals. Only seven hospitals in Georgia earned above-average ratings, including Athens Regional Medical Center.

"Hospital staff, administrators and physicians all focus on one thing: what is best for our patients," said Patty Waller, Newton Medical’s assistant administrator of patient care service. "Most people appreciate positive reinforcement, and to be recognized for the work that our teams put into hardwiring safety in our daily routines is certainly a positive reinforcement."

She said "attention to detail and teamwork" were among the specific elements that led to the high rating.

"Like airline pilots, we have checklist that we go through each and every time a patient goes to the operating room. Everyone works together as a team and any one of the team members has the ability to halt the process if they feel anything is out of place," Waller said.

The data was analyzed by health consulting firm MPA (Michael Pine and Associates).

How to use the data

While Consumer Reports officials acknowledge the study’s limitations, they say their study is one of the few publicly available sources of surgery data and can offer at least some guidance.

"This isn’t perfect data; it has its limitations, but we think that it is the best data that is available publicly, because there isn’t really any data out there," said Santa, noting the data is indirect but gives indications of something going amiss. "We look at likelihood of either dying or a prolonged length of stay, which means something happened; we don’t know what happened."

Santa urged consumers to look at other websites to compile as much data as possible, including The Leapfrog Group and the federal government’s Hospital Compare website at medicare.gov/hospitalcompare.

Santa said each group has its own data and other methods of measuring hospitals, so it’s important to use all resources available.

Prospective patients can also ask their doctors and hospitals for information directly. He said patients should ask their surgeon for his surgery results data, and if the surgeon refuses to give it, the patient should go somewhere else, Santa said. They can also ask the hospital to talk to another patient who had the same surgery.

"You like to find out what it was like for them," Santa said. "Most patients don’t understand how much preparation is needed to manage things after the surgery. You’re not going to be able to drive for a while in many cases (after a knee or hip replacement)."

He said sometimes surgeons are more optimistic than they should be.

Patients also need to make sure communication is happening between their primary care physician and their surgeon or specialist.

Finally, consumers should make sure the surgeon is in good standing with the state’s licensing board.

Santa said many small and medium-sized rural hospitals were able to do a good job in surgery compared with bigger hospitals; the reason might be that they focus on fewer areas where they can excel.

"Many community hospitals, in the suburbs and rural areas — those hospitals realize they can’t do everything that the big hospitals do, so they decide what things they can’t do well and what (they can) do well," Santa said.

However, he noted that the Consumer Reports study was designed to put larger and smaller hospitals on the same footing, by looking at "average Joe" patients, not the toughest cases, which often get sent to big hospitals, because they are the only ones who can handle such cases.

How it ranks

While Newton Medical ranked high in surgery results, it did have some mixed results in terms of communication, the state of hospital rooms and scanning practices, according to Consumer Reports’ analysis of Hospital Consumer Assessment of Healthcare Providers and Systems survey data collected by the federal government, which can be found at the Hospital Compare website.

Newton Medical was among the best in communication between doctors and patients and nurses and patients, with 96 percent and 95 percent, respectively, of patients communicating well, and it was above average in terms of pain control (92 percent said their pain was controlled well), help from hospital staff (90 percent said help was provided quickly) and room quietness (90 percent said the area around rooms was quiet at night). However, the hospital was below average in terms of communication about drug information (83 percent said new medications were explained) and room cleanliness (83 percent said room and bathrooms were clean), while it was among the worst in communication about hospital discharge (76 percent said they were told what to watch for after leaving hospital).

The hospital also ranked below average in how often it had patients under abdominal and chest scans. Consumer Reports said 17 percent of the hospital’s patients received double scans, meaning one CT scan with contrast and one without, which Consumer Reports said "can expose patients to unnecessary radiation."

Newton Medical was average in avoiding readmissions, as heart attack patients had a 19 percent chance of being readmitted; the percentages were 19 percent for pneumonia patients and 23 percent for heart failure patients. For comparison, Rockdale Medical fared similarly in communication and room conditions, though it was above average in abdominal scanning and among the best in chest scanning and below average in readmission rates for heart attack, heart failure and pneumonia patients.

Clearview Regional Medical Center in Monroe didn’t have enough data to be ranked in surgeries, but it had overall below average marks in communication and room conditions and among the worst readmission rates, while its abdominal scanning rate was average ..

On an overall safety basis in the state, St. Mary’s Health Care System in Athens (a score of 71) was ranked the top hospital, followed by Athens Regional Medical Center (66).

Rockdale Medical had a score of 43, while Newton Medical and Clearview Regional didn’t have enough data for an overall safety score.